EP3685781A1 - Dispositif de coagulation de tissu - Google Patents

Dispositif de coagulation de tissu Download PDF

Info

Publication number
EP3685781A1
EP3685781A1 EP19153586.3A EP19153586A EP3685781A1 EP 3685781 A1 EP3685781 A1 EP 3685781A1 EP 19153586 A EP19153586 A EP 19153586A EP 3685781 A1 EP3685781 A1 EP 3685781A1
Authority
EP
European Patent Office
Prior art keywords
measuring device
tissue
optical
light
probe
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
EP19153586.3A
Other languages
German (de)
English (en)
Other versions
EP3685781B8 (fr
EP3685781B1 (fr
Inventor
Caglar Ataman
Sergio VILCHES
Hans Zappe
Alexander Neugebauer
Klaus Fischer
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Erbe Elecktromedizin GmbH
Original Assignee
Erbe Elecktromedizin GmbH
Albert Ludwigs Universitaet Freiburg
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Erbe Elecktromedizin GmbH, Albert Ludwigs Universitaet Freiburg filed Critical Erbe Elecktromedizin GmbH
Priority to PL19153586T priority Critical patent/PL3685781T3/pl
Priority to EP19153586.3A priority patent/EP3685781B8/fr
Priority to BR102020000409-3A priority patent/BR102020000409B1/pt
Priority to RU2020101946A priority patent/RU2813711C2/ru
Priority to KR1020200006665A priority patent/KR20200092880A/ko
Priority to JP2020007010A priority patent/JP7408407B2/ja
Priority to US16/748,139 priority patent/US11730530B2/en
Priority to CN202010074139.6A priority patent/CN111467027B/zh
Publication of EP3685781A1 publication Critical patent/EP3685781A1/fr
Application granted granted Critical
Publication of EP3685781B1 publication Critical patent/EP3685781B1/fr
Publication of EP3685781B8 publication Critical patent/EP3685781B8/fr
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/042—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating using additional gas becoming plasma
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00071—Insertion part of the endoscope body
    • A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
    • A61B1/00096—Optical elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00163—Optical arrangements
    • A61B1/00172—Optical arrangements with means for scanning
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00163—Optical arrangements
    • A61B1/00174—Optical arrangements characterised by the viewing angles
    • A61B1/00183—Optical arrangements characterised by the viewing angles for variable viewing angles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206—Generators therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1402—Probes for open surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01S—RADIO DIRECTION-FINDING; RADIO NAVIGATION; DETERMINING DISTANCE OR VELOCITY BY USE OF RADIO WAVES; LOCATING OR PRESENCE-DETECTING BY USE OF THE REFLECTION OR RERADIATION OF RADIO WAVES; ANALOGOUS ARRANGEMENTS USING OTHER WAVES
    • G01S17/00—Systems using the reflection or reradiation of electromagnetic waves other than radio waves, e.g. lidar systems
    • G01S17/02—Systems using the reflection of electromagnetic waves other than radio waves
    • G01S17/06—Systems determining position data of a target
    • G01S17/08—Systems determining position data of a target for measuring distance only
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00057—Light
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00166—Multiple lumina
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00589—Coagulation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00642—Sensing and controlling the application of energy with feedback, i.e. closed loop control
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00642—Sensing and controlling the application of energy with feedback, i.e. closed loop control
    • A61B2018/00648—Sensing and controlling the application of energy with feedback, i.e. closed loop control using more than one sensed parameter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00702—Power or energy
    • A61B2018/00708—Power or energy switching the power on or off
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00714—Temperature
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00779—Power or energy
    • A61B2018/00785—Reflected power
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00791—Temperature
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00904—Automatic detection of target tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00982—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00994—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combining two or more different kinds of non-mechanical energy or combining one or more non-mechanical energies with ultrasound
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/01—Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue

Definitions

  • the invention relates to a device for the treatment of biological tissue.
  • Instruments are known in particular for coagulation and ablation which act on the tissue with electrical energy.
  • the WO 2012/099974 A2 an instrument that uses electromagnetic energy, for example in the form of high-frequency current and voltage and an argon plasma for coagulation.
  • the document also refers to one or more sensors, which can be used, for example, to record the power of the energy supplied, the depth of action, the tissue temperature or other physical parameters, such as a color.
  • Electromyographic sensors for recording the electromyography of the muscularis mucosa, a calorimetric sensor, a serum level sensor and an imaging sensor are also mentioned.
  • the US 2014/0309632 A1 describes a device with an instrument for tissue ablation by means of RF energy, a corresponding measuring and monitoring system being provided for monitoring the progress of the ablation. This system is set up to record the state of the tissue, which can be done by electrical measurement on the treated tissue. Intravascular ultrasound measurement, optical coherence tomography, optical coherence reflectometry or angiography are also mentioned as measurement options.
  • the US 5,321,501 describes an optical imaging of biological tissue using an interference optical sensor with which a tissue surface can be scanned.
  • the probe can be an endoscope or angioscope and can be used to scan lumens.
  • Several optical paths are provided for parallel scanning.
  • the focus point can be moved to enlarge the focus.
  • This probe system uses optical coherence tomography as the measurement method and can use it to perform a linear, flat or depth-graded scanning on a tissue surface. Such scans are referred to as A-Scan, B-Scan or C-Scan. In at least one embodiment, this probe can also be designed as an HF ablation probe.
  • the US 9,060,750 B2 describes a system with an instrument that acts on a tissue by argon-plasma coagulation.
  • the presence of certain chemical substances is inferred by means of optical emission spectroscopy, in which the light captured is examined.
  • the US 7,720,532 B2 describes an integrated instrument that can be used as a versatile measuring instrument. It contains an ultrasound sensor comprising a plurality of ultrasound transducers and an electrical sensor with a central electrode and a ring-shaped electrode arranged radially around it, which are arranged together with the ultrasound transducers on the distal end face of the instrument.
  • a plasma probe which can contain one or more optical sensors which are provided for monitoring the ablation process.
  • the optical sensors can be connected to spectrometers which analyze the light captured and control the ablation process on the basis thereof.
  • the device according to the invention can be used, for example, for tissue coagulation.
  • a probe body belonging to the device has at least one electrode which can be supplied with an electrical voltage, preferably a high-frequency modulated or unmodulated voltage U HF .
  • An electrical current then emanates from the electrode and flows through a plasma and over the biological tissue to be treated. The tissue is changed, in particular coagulated and / or removed.
  • the probe body is preferably assigned at least one light guide device which is connected to a measuring device.
  • the measuring device is set up as an optical distance measuring device, as a temperature measuring device or as a tissue type determination device. You can also perform two or all of these functions and, if desired, other functions.
  • the measuring device is preferably designed as an interferometric distance measuring device that works with multicolored light and enables absolute distance determination. Short-coherent light with a coherence length that is less than the target distance of the probe from the tissue, in particular white light, can be used as light. Long-coherent light with a coherence length that is greater than the desired distance of the probe from the tissue can also be used as light.
  • the light-guiding device has a light-receiving window that defines an observation area. This observation area overlaps at least partially with the plasma beam or spark emanating from the probe body.
  • the light receiving window can be formed on a GRIN lens or a lens array, which preferably forms a plurality of optical axes and / or a plurality of focal points.
  • the optical axes make an acute angle in pairs, i.e. an angle of at most 90 °. They can also be oriented parallel to one another.
  • the GRIN lens or the lens array is preferably connected to a monofilament light guide device and this in turn is connected to an optical measuring device.
  • the optical measuring device is used for the distance measurement, light can be delivered to the (all) optical axes and focal points via the light guide, and light which is scattered back from them is delivered to the measuring device via the light guide device. This receives the light scattered back from the different points of impact of the light of the different optical axes and brings it to interference with the light from the light source.
  • the distances between the tissue and the probe on the individual optical axes can be determined from the interference pattern obtained. Even if the determined distances cannot be individually assigned to individual focal points or optical axes, the measuring device can nevertheless be set up to determine at least the smallest measured distance (minimum distance) or also another desired size, such as, for example, the mean or the largest distance.
  • the distance measuring device is preferably an interferometric distance measuring device.
  • This uses a light source with sufficient coherence length, at least one beam splitter, a light receiver, light guide and a lens.
  • the lens can be a GRIN lens;
  • the beam splitter can be a fiber coupler;
  • the light guides can be optical fibers;
  • the light receiver can be a photodiode or a photodiode array, for example in the form of a camera chip.
  • That of the light guides and the at least one beam splitter Fixed light path can contain a measuring path and a reference path.
  • the reference path and the measuring path can include the same optical elements, in particular the lens, which is preferably designed as a GRIN lens, and the part of the light path (for example the light guide) leading from the beam splitter to the lens.
  • the end surface of the lens (eg the GRIN lens) facing the tissue can serve as a reference mirror.
  • the device can be designed in such a way that the operation of the probe, in particular the activation of the electrode and a plasma beam possibly emanating from it, is made dependent on the observance of certain distances, in particular on the non-shortfall of the minimum distance. Because the different optical axes of the GRIN lens or the lens arrangement meet a tissue to be treated at different points, it can thus be ensured by means of several points of impact that the biological tissue does not come too close to the probe at any point.
  • the probe according to the invention can be used in particular in a surgical robot.
  • the distance measuring device makes this considerably easier.
  • the distance between the probe and the tissue can be set much more easily using the distance measurement than using a camera image. This enables remote control of the probe or semi-automatic or fully automatic probe control.
  • the probe can have one or more electrodes.
  • the probe can be combined with another probe of a similar design or of identical construction to form a double probe.
  • the light-guiding device can be provided in the probe body, on the probe body or also on a holder which, for example, accommodates one or more probe bodies. According to this principle, different probe configurations can be created, which are adapted to different uses or locations.
  • the light guiding device is at the same time set up to illuminate the measuring location and also to return the light backscattered from the measuring location to the measuring device.
  • the measuring device is preferably designed such that it is activated during breaks in which no light emits from the electrode and in particular from the spark or plasma emanating from the electrode. If, for example, pulsed RF voltage U HF is applied to the electrode, the interferometric measuring device is preferably active in the pulse pauses of the RF voltage U HF .
  • the measuring device can also be used as a pyrometric temperature measuring device. In this case, it is set up to record the light emanating from the treated tissue, in particular infrared light, and to determine the temperature of the tissue on the basis of its spectral composition. In this case, the measuring device is preferably in turn aligned to be activated during pulse pauses of a pulsed HF voltage U HF with which the electrode is applied.
  • the measuring device can also be a combined measuring device which performs both an interferometric distance determination and a pyrometric temperature measurement.
  • the measuring device can additionally or exclusively be set up to determine the tissue type detected by the plasma or spark by means of optical emission spectroscopy.
  • the measuring device is preferably set up to receive and analyze light during the pulses of the pulsed treatment voltage (HF voltage U HF ).
  • the analysis of the light is preferably a spectral analysis. in the context of which the light emanating from the spark or plasma is subjected to a spectral examination.
  • the measured spectra can be compared with reference spectra of certain tissue types to differentiate between tissues.
  • the spectral lines of chemical elements typical of certain tissue layers can also serve as an indicator for tissue layers, for example the spectral lines of magnesium or calcium.
  • optical emission spectroscopy ES the intensity of the light signal is strongly dependent on the distance.
  • the optical measuring device is set up to calculate the measured distance with the light signal, for example to convert it to the distance with which the comparison spectrum was recorded, the disturbing influence of changing distances during treatment disappears. It is therefore expedient if the optical measuring device is designed such that it uses both the spectrum and the distance to determine the tissue type.
  • the measuring device can also be set up to be permanently active in order to determine the distance of the probe from the tissue and / or the temperature of the tissue during the pulse pauses and to determine the tissue composition during the pulses.
  • the invention also includes a method for tissue ablation in which the ablation progress and / or the distance of the probe body from the surface of a biological tissue and / or the tissue type are determined by means of the optical measuring device.
  • the method is particularly suitable for mucosal ablation.
  • layer-specific emission spectra ES
  • the penetration of the ablating plasma into the submucosal layer can be recorded and displayed by an increase in at least one ES signal from magnesium compared to the mucosal layer.
  • the penetration of the ablating plasma into the submucosal layer can also be detected and displayed by an increase relative to the mucosal layer of at least one ES signal from calcium.
  • a coincidence of the increase in the ES signal from magnesium with an increase in the ES signal from calcium or another marker can be used as an indicator of the penetration of the plasma into the submucosa.
  • the penetration of the ablating plasma into the muscularis extern can be detected and displayed by an increase relative to the mucosal layer of at least one ES signal from magnesium
  • the penetration of the ablating plasma into the muscularis propria (muscle layer) can also be detected and displayed by an increase relative to the mucosal layer of at least one ES signal from calcium or another marker.
  • FIG. 1 A device 10 is illustrated which can be used for tissue coagulation, for tissue ablation or for other tissue treatment.
  • the device 10 includes a probe 11 and a supply device 12 feeding the probe 11. This can be formed by one or more devices and is shown in FIG Figure 1 represented simply as a block.
  • the subsequent use of the term “device 12” also encompasses a number of devices that are combined in operative terms.
  • the probe 11 can be an endoscopic probe or an instrument for laparoscopic use or for open surgical use. Unless this is excluded in principle, the structural and functional details explained below apply to each of these types.
  • the probe 11 is connected via one or more lines 13 and one or more plugs 14 to the device 12, which provides the operating power and the media for the operation of the probe 11.
  • the probe 11 has a rigid or flexible probe body 15, in or on which an electrode 16 is held.
  • the electrode 16 is arranged in a fluid channel 17 which extends longitudinally through the probe body 15 and leads to the plug 14 and through which extends an electrical line which supplies the electrode 16 with electrical power.
  • the fluid channel 17 preferably opens at an end face 18 of the distal end of the probe body 15.
  • the probe body 15 can also be provided with a light-guiding device 19 which extends from the distal end of the probe body 15 to the Plug 14 extends.
  • the light guide device 19 At the distal end of the light guide device 19 there is an opening 20 through which light can enter and exit and can thus be emitted from the light guide device 19 to a treatment site and received by the latter.
  • the fluid channel 17 and the light-guiding device 19 preferably run in the same direction through the probe body 15.
  • Figure 4 illustrates a further modification in which two probes 11a, 11b are combined to form a twin probe.
  • the two probes 11a, 11b can be constructed identically or differently. They can be designed with or without an optical light-guiding device and with or without light entry or exit windows.
  • a light guide device 19 is attached to a holder 21, which connects the two probes 11a, 11b to one another.
  • the probe variants presented by Figures 2 to 4 are examples that can be combined.
  • the probes can be used Figure 2 and 3 with a holder after Figure 4 can be combined into a twin probe.
  • One of the probes can also be used Figure 2 or 3 with one of the probes 15a or 15b in the holder 21 Figure 4 can be combined into a twin probe. All of these arrangements have in common that they contain at least one electrode 16, at least one light guide 19 and at least one fluid channel 17. Correspondingly there are at least one electrical generator 22 in the device 12, which is connected via the plug 14 and the line 13 is connected to the electrode 16, a gas source 23, which is connected via the connector 14 and the line 13 to the fluid channel 17, and a measuring device 24 is provided, which via the connector 14 and the line 13 to the light guide device 19 is connected.
  • the generator 22 is preferably a controllable high-voltage generator controlled by a control circuit (not shown further). It is preferably set up to emit a high-frequency alternating voltage U HF, preferably at a frequency of well above 100 kHz, for example 350 kHz. It is also set up to modulate the high-frequency alternating voltage U HF , for example with a square wave, so that there is a pulsed voltage output with pulses 25 and pauses 26, as is the case Figure 10 for the high-frequency AC voltage U HF is illustrated.
  • the controller or generator 22 can be set up to vary the ratio of the time periods of the pulses 25 and pauses 26 according to predetermined settings, predetermined modes or else according to control signals.
  • the gas source 23 can also be connected to the control device (not illustrated further) in order to selectively enable or block a gas flow and / or to set the flow rate.
  • the gas flow can be blocked and released and / or the flow rate can be set according to user settings, according to selected operating modes and / or using control signals.
  • the measuring device 24 is an optical measuring device which is used as an optical distance measuring device and / or as a pyrometric temperature measuring device and / or as a measuring device for determining the type of tissue, preferably on the basis of optical emission spectroscopy. If the opotic measuring device 24 determines several variables at the same time, for example distance and temperature or distance and tissue type, better accuracies for the temperature or the tissue type can be achieved than without taking the distance into account.
  • a lens arrangement 27 serving as an objective can be arranged, which comprises, for example, a GRIN lens 28.
  • This can be designed such that it splits or splits the beam path into a plurality of optical axes 29, 30, 31.
  • a central optical axis 31 can be identical to the optical axis 31 of the light guide device 19.
  • Further optical axes 29, 30 (for example 6 in number) can be arranged on a cone jacket around the optical axis 31.
  • the optical axes 29, 30, 31 can form an angle with one another in pairs, preferably an angle of at most 90 °, ie an acute angle.
  • Figure 6 illustrated for lens assembly 27 of FIG Figure 5 in accordance with the resulting light bundles, which can be focused and thus define focal points 32, 33, 34. These are preferably arranged on a common surface 35, for example a sphere, a cylindrical surface or a plane. In addition, they are preferably at a distance from the GRIN lens 28 that approximately corresponds to the distance the GRIN lens 28 is from a biological tissue 36 when the probe 15 is used, as shown in FIG Figure 7 is indicated schematically.
  • FIG. 7 illustrates schematically and mainly limited to the optical components the structure of the measuring device 24, which is designed as an interferometric measuring device for distance control or distance measurement.
  • the measuring device includes a light source 37, for example in the form of a white light source or a tunable laser. This is connected to the light guide device 19 via a fiber coupler 38, which serves as a beam splitter.
  • the fiber coupler 38 is also connected to a light receiver 39 which receives both parts of the light emitted by the light source 37 and parts of the light reflected by the surface of the fabric 36. If necessary, a reference light path terminated with a reflector can be coupled to the beam path via a further fiber coupler 38 '.
  • the light path in the portion of the light guide 19 from the steel splitter 38 to the GRIN lens to the end face thereof serves as a reference light path.
  • the end surface of the GRIN lens (or another lens) reflects part of the light and thus forms the reference mirror.
  • a separate reference light path can be omitted.
  • the interferometer can be designed to work both with short-coherent light (white light interferometer) and with light of a longer coherence length.
  • a tunable is used for measuring the distance in the measuring device 24
  • Light source 37 used which can emit light of variable wavelength.
  • the individual spectral lines of the light spectrum are received one after the other when tuning the light source 37.
  • Figure 8 generated by spectral decomposition of the light supplied by the fiber coupler 38 to the light receiver 39 and registered and generated by a corresponding plurality of light receiving elements.
  • the measuring device 24 can be set up to determine the smallest of the distance values d 1 , d 2 , d 3 and to make this available to the control of the device 12 for further processing.
  • the controller can control the generator 22, for example switch it on and off, or influence its performance and / or its duty cycle (pulse, pause ratio).
  • the controller can also use this smallest distance value d 1 to switch the gas source 23 on or off or to initiate increased or reduced gas delivery.
  • the interference optical measuring device 24 described so far is active during the pauses 26 of the pulsed RF voltage U HF applied to the electrode 16, as shown in FIG Figure 10 is illustrated in the top diagram for the first optical measurement O 1 .
  • the generator 22, as is Figure 9 schematically represents, communicate directly or through the control of the device 12 with the optical measuring device 24 so that the measuring device 24 works synchronized to the generator 22.
  • the measuring device 24 it carries out a tissue surface temperature measurement, in that it also detects the radiation emanating from the surface of the tissue 36, in particular infrared radiation, during the breaks 26 and uses this to carry out pyrometric temperature detection.
  • the optical measuring device 24 is used as part of a tissue determination or classification device which determines the type of tissue hit by the spark or the plasma by optical emission spectroscopy.
  • This measurement is in Figure 10 illustrated in the lower diagram O 2 .
  • the measuring device 24 for performing this measurement is preferably active during the pulses 25.
  • the light source 37 is inactive or is omitted entirely.
  • the fiber coupler 38 (and, if present, the fiber coupler 38 ') can also be omitted.
  • the light receiver 39 receives the light emanating from the spark or plasma and in turn determines the spectrum thereof in accordance with the illustration in FIG Figure 8 Left. The acquired spectrum can be compared with a reference spectrum in order to determine the tissue type conclude.
  • the typical spectral lines of magnesium and / or calcium can also be determined, from their presence and size let, with which of the layers the plasma is induced, ie which layer is unloaded.
  • the measuring device 24 can accordingly generate one or more control signals which identify the smallest distance of the probe from the tissue and / or the tissue temperature and / or the tissue type.
  • the control device of the device 12 can be set up to control the generator 22 and / or the gas source 23 in accordance with this signal.
  • the control device can stop the generator 22 as soon as the minimum distance between the probe and the tissue is undershot.
  • the control device can deactivate the gas source 23.
  • the probe can be guided completely, or at least with regard to its distance to the tissue, in that a distance control device automatically sets the desired treatment distance between the probe and the tissue on the basis of the distance measurement.
  • the measured distance it is also possible to display the measured distance to an operator during operation of the probe so that the operator is not solely dependent on a camera image when the probe is being guided.
  • the control device can deactivate the generator 22 and / or the gas source 23 as soon as the measuring device 24 uses the optical emission spectrum of the plasma or the spark to determine the influence of a tissue type that is not to be influenced.
  • the interaction of the measuring device 24 with, for example, the generator 22 is shown in FIG Figure 9 schematically illustrated. It can go beyond switching the generator 22 and / or the gas source 23 on and off.
  • the pulse / pause ratio of the generator 22 and / or the size of the gas flow of the gas source 23 can be set or regulated using the control signal.
  • the pulse / pause ratio of the HF voltage U HF emitted by the HF generator 24 can be reduced if the tissue temperature measured by the measuring device exceeds a limit value.
  • the gas flow from the gas source 23 can be increased or decreased. In this way, an automatic adaptation of the operation of the generator 22 and / or the gas source 23 to the respective temporary operating states of the probe 11 can be achieved.
  • a probe 16 which can belong to a medical instrument, can be provided with a high-voltage electrode 16 and a light guide device 19, which is connected to a measuring device 24.
  • This can be designed as an optical distance measuring device and / or as a temperature measuring device and at least optionally also as a device for determining the treated tissue type by means of optical emission spectroscopy.
  • the optical measuring device serves as a distance measuring device, it is particularly preferably designed as an interference-optical measuring device which is set up to measure the distance of the To determine the probe or the light guide from several points of the treated tissue simultaneously.
  • the device 10 can be used for tissue coagulation and / or for tissue ablation. It comprises at least one electrode 16, which is used to generate a spark or a plasma beam and can be connected to an electrical source 20 for this purpose.
  • a probe 24 is assigned to the probe 11, which emits and / or records light in the vicinity of the electrode 16 and determines the distance of the probe 11 from the tissue 36 and / or the tissue temperature and / or the composition of the affected tissue 36.
  • the measuring device 24 is preferably operated synchronized with pulses or pauses in the pulse-pause-modulated HF voltage U HF of the electrode 16, in order to simultaneously carry out the desired measurements during operation of the instrument 11 and to regulate the operation of the instrument 11 on the basis of the measurement results obtained can.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Physics & Mathematics (AREA)
  • Public Health (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Otolaryngology (AREA)
  • Plasma & Fusion (AREA)
  • Pathology (AREA)
  • Biophysics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Optics & Photonics (AREA)
  • Electromagnetism (AREA)
  • Radar, Positioning & Navigation (AREA)
  • Remote Sensing (AREA)
  • General Physics & Mathematics (AREA)
  • Robotics (AREA)
  • Computer Networks & Wireless Communication (AREA)
  • Investigating Or Analysing Materials By Optical Means (AREA)
  • Surgical Instruments (AREA)
  • Investigating, Analyzing Materials By Fluorescence Or Luminescence (AREA)
  • Investigating Or Analysing Biological Materials (AREA)
EP19153586.3A 2019-01-24 2019-01-24 Dispositif de coagulation de tissu Active EP3685781B8 (fr)

Priority Applications (8)

Application Number Priority Date Filing Date Title
PL19153586T PL3685781T3 (pl) 2019-01-24 2019-01-24 Przyrząd do koagulacji tkanek
EP19153586.3A EP3685781B8 (fr) 2019-01-24 2019-01-24 Dispositif de coagulation de tissu
BR102020000409-3A BR102020000409B1 (pt) 2019-01-24 2020-01-08 Dispositivo para a coagulação de tecidos
KR1020200006665A KR20200092880A (ko) 2019-01-24 2020-01-17 조직 응고를 위한 디바이스
RU2020101946A RU2813711C2 (ru) 2019-01-24 2020-01-17 Устройство для коагуляции биологической ткани
JP2020007010A JP7408407B2 (ja) 2019-01-24 2020-01-20 組織凝固用の装置
US16/748,139 US11730530B2 (en) 2019-01-24 2020-01-21 Device for tissue coagulation
CN202010074139.6A CN111467027B (zh) 2019-01-24 2020-01-22 用于组织凝固的装置

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
EP19153586.3A EP3685781B8 (fr) 2019-01-24 2019-01-24 Dispositif de coagulation de tissu

Publications (3)

Publication Number Publication Date
EP3685781A1 true EP3685781A1 (fr) 2020-07-29
EP3685781B1 EP3685781B1 (fr) 2022-04-13
EP3685781B8 EP3685781B8 (fr) 2022-06-29

Family

ID=65234435

Family Applications (1)

Application Number Title Priority Date Filing Date
EP19153586.3A Active EP3685781B8 (fr) 2019-01-24 2019-01-24 Dispositif de coagulation de tissu

Country Status (6)

Country Link
US (1) US11730530B2 (fr)
EP (1) EP3685781B8 (fr)
JP (1) JP7408407B2 (fr)
KR (1) KR20200092880A (fr)
CN (1) CN111467027B (fr)
PL (1) PL3685781T3 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3964822A1 (fr) * 2020-09-03 2022-03-09 Erbe Elektromedizin GmbH Dispositif et procédé d'analyse tissulaire

Families Citing this family (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20240058062A1 (en) * 2020-12-15 2024-02-22 Ne Scientific, Llc System and method for ablation treatment of tissue with interactive guidance
EP4183357A1 (fr) * 2021-11-18 2023-05-24 Erbe Elektromedizin GmbH Instrument médical
CN114886545B (zh) * 2022-05-07 2023-11-28 宇寿医疗科技(无锡)有限公司 一种同步双极性短脉冲肿瘤消融方法与装置
CN114886546B (zh) * 2022-05-09 2023-11-28 宇寿医疗科技(无锡)有限公司 一种同步双极性短脉冲肿瘤消融方法与***
EP4342403A1 (fr) * 2022-09-22 2024-03-27 Erbe Elektromedizin GmbH Procédé de détermination d'un état d'un guide d'ondes optique d'un instrument électrochirurgical et système comprenant un instrument électrochirurgical

Citations (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5321501A (en) 1991-04-29 1994-06-14 Massachusetts Institute Of Technology Method and apparatus for optical imaging with means for controlling the longitudinal range of the sample
DE19860689A1 (de) * 1998-12-29 2000-08-24 Erbe Elektromedizin Verfahren und Vorrichtung zum Entfernen von Rauch
DE10392791T5 (de) * 2002-06-11 2005-05-25 Intraluminal Therapeutics Inc., Carlsbad Hochfrequenz-Führungsdrahtanordnung mit Führung durch optische Kohärenz-Reflexionsmessung
US20070213704A1 (en) 1999-05-24 2007-09-13 Arqos Surgical Inc. Electrical discharge devices and techniques for medical procedures
US7720532B2 (en) 2004-03-23 2010-05-18 Dune Medical Ltd. Clean margin assessment tool
WO2010104752A2 (fr) 2009-03-08 2010-09-16 Oprobe, Llc Système de sonde optique multifonction pour applications médicales et vétérinaires
WO2012099974A2 (fr) 2011-01-19 2012-07-26 Fractyl Laboratories, Inc. Dispositifs et procédés de traitement de tissus
US20120289954A1 (en) 2009-11-09 2012-11-15 Amnon Lam Micro plasma head for medical applications
WO2013164109A1 (fr) * 2012-05-02 2013-11-07 Erbe Elektromedizin Gmbh Dispositif électrochirurgical comprenant des moyens destinés à produire un phénomène optique et à réaliser une différenciation tissulaire par analyse de la lumière
US20140309632A1 (en) 2013-03-15 2014-10-16 Retrovascular, Inc. Methods for tissue ablation measurement and control and devices thereof
EP2815695A1 (fr) * 2013-06-20 2014-12-24 Erbe Elektromedizin GmbH Instrument chirurgical doté d'une reconnaissance de tissus
US9060750B2 (en) 2009-11-09 2015-06-23 Ionmed Ltd. Plasma head for tissue welding

Family Cites Families (19)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080154257A1 (en) 2006-12-22 2008-06-26 Shiva Sharareh Real-time optoacoustic monitoring with electophysiologic catheters
US5608520A (en) * 1994-07-11 1997-03-04 The United States Of America As Represented By He Department Of Energy Plasma emission spectroscopy method of tumor therapy
DE19721362B4 (de) 1997-04-01 2011-05-26 Axel Muntermann Vorrichtung und Eichverfahren zur Katheterablation
RU2126986C1 (ru) 1997-11-24 1999-02-27 АРСЕНИЧ Святослав Иванович Оптический растровый конденсор и оптическое изделие с растровым конденсором
EP1272117A2 (fr) * 2000-03-31 2003-01-08 Rita Medical Systems, Inc. Appareil et procede de biopsie et traitement tissulaire
RU2217035C1 (ru) 2002-03-27 2003-11-27 Государственное унитарное предприятие "НПО Астрофизика" Градиентный сверхтонкий жесткий эндоскоп
DE10323422B4 (de) 2002-08-23 2022-05-05 Carl Zeiss Meditec Ag Vorrichtung und Verfahren zur Messung eines optischen Durchbruchs in einem Gewebe
US20060229515A1 (en) 2004-11-17 2006-10-12 The Regents Of The University Of California Fiber optic evaluation of tissue modification
RU2384955C1 (ru) 2009-04-08 2010-03-20 Закрытое акционерное общество "Центральный научно-исследовательский технологический институт "Техномаш-ВОС" (ЗАО "ЦНИТИ "Техномаш-ВОС") Волоконно-оптическая система передачи информации
DE102010011643B4 (de) * 2010-03-16 2024-05-29 Christian Buske Vorrichtung und Verfahren zur Plasmabehandlung von lebendem Gewebe
RU2510248C2 (ru) 2012-04-23 2014-03-27 Федеральное государственное бюджетное учреждение науки Институт физики твердого тела Российской академии наук (ИФТТ РАН) Способ удаления опухолей мозга с выделением границ опухоли флуоресцентной диагностикой с одновременной коагуляцией и аспирацией и устройство для его осуществления
US20140188095A1 (en) * 2012-12-31 2014-07-03 Paul Joseph Weber Apparatus and systems for tissue dissection and modification
US20140188092A1 (en) * 2012-12-31 2014-07-03 Omni Medsci, Inc. Focused near-infrared lasers for non-invasive vasectomy and other thermal coagulation or occlusion procedures
EP4233991A1 (fr) 2013-03-15 2023-08-30 Medtronic Ardian Luxembourg S.à.r.l. Systèmes de neuromodulation contrôlée
GB201308558D0 (en) 2013-05-13 2013-06-19 Creo Medical Ltd Electrosurgical apparatus
JP6510538B2 (ja) 2014-01-08 2019-05-08 ベスビウス グループ，ソシエテ アノニム 光学パイロメータ
CN111317565B (zh) 2014-05-18 2023-05-09 爱克斯莫医疗有限公司 使用脉冲激光器进行组织消融的***
EP3141204B1 (fr) 2015-09-10 2021-07-28 Erbe Elektromedizin GmbH Systeme d'ablation destine a la coagulation extensive de tissus biologiques
US11974798B2 (en) 2018-07-17 2024-05-07 Biosense Webster (Israel) Ltd. Temperature-controlled pulsed RF ablation

Patent Citations (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5321501A (en) 1991-04-29 1994-06-14 Massachusetts Institute Of Technology Method and apparatus for optical imaging with means for controlling the longitudinal range of the sample
DE19860689A1 (de) * 1998-12-29 2000-08-24 Erbe Elektromedizin Verfahren und Vorrichtung zum Entfernen von Rauch
US20070213704A1 (en) 1999-05-24 2007-09-13 Arqos Surgical Inc. Electrical discharge devices and techniques for medical procedures
DE10392791T5 (de) * 2002-06-11 2005-05-25 Intraluminal Therapeutics Inc., Carlsbad Hochfrequenz-Führungsdrahtanordnung mit Führung durch optische Kohärenz-Reflexionsmessung
US7720532B2 (en) 2004-03-23 2010-05-18 Dune Medical Ltd. Clean margin assessment tool
WO2010104752A2 (fr) 2009-03-08 2010-09-16 Oprobe, Llc Système de sonde optique multifonction pour applications médicales et vétérinaires
US20120289954A1 (en) 2009-11-09 2012-11-15 Amnon Lam Micro plasma head for medical applications
US9060750B2 (en) 2009-11-09 2015-06-23 Ionmed Ltd. Plasma head for tissue welding
WO2012099974A2 (fr) 2011-01-19 2012-07-26 Fractyl Laboratories, Inc. Dispositifs et procédés de traitement de tissus
WO2013164109A1 (fr) * 2012-05-02 2013-11-07 Erbe Elektromedizin Gmbh Dispositif électrochirurgical comprenant des moyens destinés à produire un phénomène optique et à réaliser une différenciation tissulaire par analyse de la lumière
US20140309632A1 (en) 2013-03-15 2014-10-16 Retrovascular, Inc. Methods for tissue ablation measurement and control and devices thereof
EP2815695A1 (fr) * 2013-06-20 2014-12-24 Erbe Elektromedizin GmbH Instrument chirurgical doté d'une reconnaissance de tissus

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3964822A1 (fr) * 2020-09-03 2022-03-09 Erbe Elektromedizin GmbH Dispositif et procédé d'analyse tissulaire

Also Published As

Publication number Publication date
US11730530B2 (en) 2023-08-22
CN111467027A (zh) 2020-07-31
BR102020000409A8 (pt) 2023-03-21
JP7408407B2 (ja) 2024-01-05
RU2020101946A (ru) 2021-07-19
KR20200092880A (ko) 2020-08-04
EP3685781B8 (fr) 2022-06-29
US20200237421A1 (en) 2020-07-30
CN111467027B (zh) 2023-07-14
PL3685781T3 (pl) 2022-07-11
JP2020121116A (ja) 2020-08-13
EP3685781B1 (fr) 2022-04-13
BR102020000409A2 (pt) 2020-08-04

Similar Documents

Publication Publication Date Title
EP3685781B1 (fr) Dispositif de coagulation de tissu
DE4229817C2 (de) Verfahren zur zerstörungsfreien und/oder nichtinvasiven Messung einer Temperaturänderung im Inneren eines insbesondere lebenden Objektes
DE10031818A1 (de) Endoskopsystem
DE112020003749T5 (de) Selektives laserzünden für gewebesicherheit
EP2074940A1 (fr) Dispositif de traitement ou d'examen dentaire
WO2017085110A1 (fr) Procédé et dispositif de détermination in vivo optique non invasive de la concentration de glucose dans le sang en circulation
DE112021003889T5 (de) Laserbehandlung mit akustischer rückkopplung
DE112016000245T5 (de) Blutgefäßerkennungsvorrichtung und chirurgische Behandlungsvorrichtung
DE10249674B4 (de) Operationsinstrument zum Schneiden, Abtragen oder Absaugen von Material in einem Operationsgebiet
DE112020003713T5 (de) Endoskopisches lasersystem mit laserverriegelung
EP3458841B1 (fr) Microscope laser avec fonction d'ablation
DE4102614C2 (de) Endoskop zum Inspizieren von Körperhöhlen, insbesondere zur Tumor-Detektierung
EP0845238B1 (fr) Dispositif destiné au diagnostic par endoscopie et au traitement de tissus
EP3964822B1 (fr) Dispositif et procédé d'analyse tissulaire
DE19854292C2 (de) Verfahren und Anordnung zur multiparametrischen Diagnostik von biologischem Gewebe
DE10115426C2 (de) Vorrichtung und Verfahrens zur Laser-Ablation von organischem und anorganischem Material
DE19854291C2 (de) Endoskopische Anordnung zum Untersuchen von biologischem Gewebe
DE19530847C2 (de) Vorrichtung und Verfahren zur Darstellung von Gewebeveränderungen
DE102020105835A1 (de) Verfahren und System zur Unterstützung eines HF-chirurgischen Eingriffs sowie Softwareprogrammprodukt
LU92886B1 (de) Kontrollanordnung zur intraoperativen Stimulierbarkeit von durch das Nervensystem gesteuerten Funktionen
RU2813711C2 (ru) Устройство для коагуляции биологической ткани
EP3984481B1 (fr) Dispositif de test
DE102023126616A1 (de) Spektrale erkennung des blinkens einer optischen faser
DE102022115164A1 (de) Chirurgisches Werkzeug und elektrochirurgisches Handinstrument sowie Verfahren zur Erkennung eines chirurgischen Werkzeugs
DE102023126770A1 (de) Koaxiale lichtwellenleiter-entfernungsmessung mit lichtlaufzeit

Legal Events

Date Code Title Description
PUAI Public reference made under article 153(3) epc to a published international application that has entered the european phase

Free format text: ORIGINAL CODE: 0009012

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: THE APPLICATION HAS BEEN PUBLISHED

AK Designated contracting states

Kind code of ref document: A1

Designated state(s): AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR

AX Request for extension of the european patent

Extension state: BA ME

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: REQUEST FOR EXAMINATION WAS MADE

17P Request for examination filed

Effective date: 20201030

RBV Designated contracting states (corrected)

Designated state(s): AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR

RIC1 Information provided on ipc code assigned before grant

Ipc: A61B 18/14 20060101AFI20210622BHEP

Ipc: A61B 18/00 20060101ALN20210622BHEP

Ipc: A61B 18/22 20060101ALN20210622BHEP

GRAP Despatch of communication of intention to grant a patent

Free format text: ORIGINAL CODE: EPIDOSNIGR1

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: GRANT OF PATENT IS INTENDED

RIC1 Information provided on ipc code assigned before grant

Ipc: A61B 18/22 20060101ALN20210831BHEP

Ipc: A61B 18/00 20060101ALN20210831BHEP

Ipc: A61B 18/14 20060101AFI20210831BHEP

INTG Intention to grant announced

Effective date: 20210924

GRAJ Information related to disapproval of communication of intention to grant by the applicant or resumption of examination proceedings by the epo deleted

Free format text: ORIGINAL CODE: EPIDOSDIGR1

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: REQUEST FOR EXAMINATION WAS MADE

GRAP Despatch of communication of intention to grant a patent

Free format text: ORIGINAL CODE: EPIDOSNIGR1

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: GRANT OF PATENT IS INTENDED

INTC Intention to grant announced (deleted)
RIC1 Information provided on ipc code assigned before grant

Ipc: A61B 18/22 20060101ALN20211208BHEP

Ipc: A61B 18/00 20060101ALN20211208BHEP

Ipc: A61B 18/14 20060101AFI20211208BHEP

INTG Intention to grant announced

Effective date: 20220104

GRAS Grant fee paid

Free format text: ORIGINAL CODE: EPIDOSNIGR3

GRAA (expected) grant

Free format text: ORIGINAL CODE: 0009210

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: THE PATENT HAS BEEN GRANTED

AK Designated contracting states

Kind code of ref document: B1

Designated state(s): AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR

REG Reference to a national code

Ref country code: GB

Ref legal event code: FG4D

Free format text: NOT ENGLISH

REG Reference to a national code

Ref country code: CH

Ref legal event code: EP

REG Reference to a national code

Ref country code: DE

Ref legal event code: R096

Ref document number: 502019004017

Country of ref document: DE

REG Reference to a national code

Ref country code: IE

Ref legal event code: FG4D

Free format text: LANGUAGE OF EP DOCUMENT: GERMAN

REG Reference to a national code

Ref country code: AT

Ref legal event code: REF

Ref document number: 1482797

Country of ref document: AT

Kind code of ref document: T

Effective date: 20220515

REG Reference to a national code

Ref country code: DE

Ref legal event code: R081

Ref document number: 502019004017

Country of ref document: DE

Owner name: ERBE ELEKTROMEDIZIN GMBH, DE

Free format text: FORMER OWNERS: ALBERT-LUDWIGS-UNIVERSITAET FREIBURG, 79098 FREIBURG, DE; ERBE ELEKTROMEDIZIN GMBH, 72072 TUEBINGEN, DE

RAP2 Party data changed (patent owner data changed or rights of a patent transferred)

Owner name: ERBE ELEKTROMEDIZIN GMBH

REG Reference to a national code

Ref country code: CH

Ref legal event code: PK

Free format text: BERICHTIGUNG B8

REG Reference to a national code

Ref country code: LT

Ref legal event code: MG9D

REG Reference to a national code

Ref country code: NL

Ref legal event code: MP

Effective date: 20220413

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: NL

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220413

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: SE

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220413

Ref country code: PT

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220816

Ref country code: NO

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220713

Ref country code: LT

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220413

Ref country code: HR

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220413

Ref country code: GR

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220714

Ref country code: FI

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220413

Ref country code: ES

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220413

Ref country code: BG

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220713

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: RS

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220413

Ref country code: LV

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220413

Ref country code: IS

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220813

REG Reference to a national code

Ref country code: DE

Ref legal event code: R097

Ref document number: 502019004017

Country of ref document: DE

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: SM

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220413

Ref country code: SK

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220413

Ref country code: RO

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220413

Ref country code: EE

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220413

Ref country code: DK

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220413

Ref country code: CZ

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220413

PLBE No opposition filed within time limit

Free format text: ORIGINAL CODE: 0009261

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: NO OPPOSITION FILED WITHIN TIME LIMIT

26N No opposition filed

Effective date: 20230116

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: AL

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220413

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: SI

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220413

REG Reference to a national code

Ref country code: CH

Ref legal event code: PL

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: LU

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20230124

REG Reference to a national code

Ref country code: BE

Ref legal event code: MM

Effective date: 20230131

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: LI

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20230131

Ref country code: CH

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20230131

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: BE

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20230131

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: IE

Free format text: LAPSE BECAUSE OF NON-PAYMENT OF DUE FEES

Effective date: 20230124

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: DE

Payment date: 20240129

Year of fee payment: 6

Ref country code: GB

Payment date: 20240123

Year of fee payment: 6

PGFP Annual fee paid to national office [announced via postgrant information from national office to epo]

Ref country code: PL

Payment date: 20240110

Year of fee payment: 6

Ref country code: IT

Payment date: 20240123

Year of fee payment: 6

Ref country code: FR

Payment date: 20240125

Year of fee payment: 6

PG25 Lapsed in a contracting state [announced via postgrant information from national office to epo]

Ref country code: MC

Free format text: LAPSE BECAUSE OF FAILURE TO SUBMIT A TRANSLATION OF THE DESCRIPTION OR TO PAY THE FEE WITHIN THE PRESCRIBED TIME-LIMIT

Effective date: 20220413